Sarah Wollaston interview: Politicians can do more to be respected

Cross-party action is needed to ease the pain of funding health services – and it’s time to take ideas from everyone’s manifesto, says the doctor-turned-Tory MP.

A reasoned argument on Twitter is an oxymoron I think,” says Sarah Wollaston, sipping a one-shot cappuccino, fresh (in a figurative sense) from a barrage of online abuse. It’s the day after the government survived a vote on scrapping the public sector pay cap. In the preceding Commons debate, Wollaston called on ministers to “think again” about the restriction, but in the event did not back Labour’s amendment to the Queen’s speech. Cue dozens of Twitter users turning their fire on the senior Tory MP, branding her a hypocrite.

“It’s a failure to understand that’s just not how politics works,” she says. If enough Tory MPs defied the party whip and supported the amendment, it could have brought down the government, triggering an election at a time of great turmoil for the Conservatives. Instead, Wollaston plans to continue to argue the case for dropping the pay cap through various channels. It’s the type of nuanced explanation that often doesn’t register on social media.

“Do I get what I want by voting against the government? No… I get what I want by making the case to ministers, making the case in parliament and the media about it, and then getting it across the line,” she says.

She cites the sustained lobbying carried out by Labour MP Stella Creasy and others including Maria Miller, chair of the Women and Equalities Committee, that led to last week’s assurance that the government will pay for women from Northern Ireland to have abortions in England.

“Actually, that persuades the government this is an issue women feel very strongly about and therefore they agree to fund it. But voting against the government in the Queen’s speech, that’s political grandstanding,” she says.

Talk of trolling in an interview earmarked to discuss the former GP’s bid to be re-elected chair of the Health Select Committee marks something of a digression. But the softly-spoken Wollaston is battle weary after an election campaign whose highlights included her office building being defaced not once but twice by a masked man armed with a spray can and a penchant for anti-Tory slogans.

On 8 June Wollaston, who has served as MP for Totnes since 2010, was re-elected with 53.7% of the vote and a majority of more than 13,000. But she watched the national campaign with unease, as the party’s “clumsily worded” proposed reforms to social care derailed much of the Tories’ core vote.

The Conservatives also earned the ire of public sector workers, fatigued after seven years of austerity. Are the Tories now considered toxic by this demographic?

“With the public sector workers… yes, I think what we saw with head teachers writing letters home to parents in effect saying ‘don’t vote for the Conservatives’, that was the subtext,” she explains.

“We had public sector workers in the NHS using social media to campaign against the Conservative party. So I think we lost the public sector. Then, by trying to be honest about funding social care – the ‘how we would pay for it’– we lost a lot of our core vote.

“I’m afraid the stuff on fox hunting, none of us saw it coming. It was just completely ridiculous. I cannot think why that went in. It was just nonsense. That triumvirate, for me, is what lost us the election.”

Wollaston wants to see the public sector pay cap lifted – “we cannot keep out finger in that dam much longer,” she insists – but is aware of the costs involved, and the need for the Tories to maintain fiscal discipline. It is up to the Treasury, she says, to work out the numbers.

But she adds: “We can’t pretend that we can keep public sector pay capped at 1% for 10 years, because that will have consequences.” What kind of consequences? “On recruitment, retention, morale,” she says. In the NHS, Wollaston points to official figures showing the number of nurses from the EU registering to work in the UK has dropped by 96% since the Brexit vote as evidence of a “collapse” in recruitment from the continent.

“That was slightly nuanced because we also brought in language-testing. But if you’re a nurse deciding where to work in the EU, because of the exchange rate and the public sector pay cap, increasingly you’ll be making that calculation that you’d be better off working in Germany or somewhere else. And it’s a very mobile market,” she says.

“But also, within the UK, a lot of people working in the health service are starting to move into the private sector to work in things like the pharmaceutical industry, or they’ve got very good transferable skills to take to other sectors.

“I think recruitment and retention will increasingly be an issue and then, of course, you have a knock-on effect. The lesson from Mid Staffs was that, without safe staffing levels, you affect patient safety. It starts to become a false economy unless you address it.”

Throughout her seven years in parliament, Wollaston has not been afraid to speak against her party on issues from the EU through to Syria. A quiet assassin, Wollaston talks so calmly and with such reassurance that the strength of many of her words only register when I read them back.

Central to our discussion is Wollaston’s appetite for politicians to work cross-party, particularly given the current makeup of the Commons. “I think people are crying out for it,” she says. But she’s concerned that this desire is not replicated unilaterally among her colleagues.

“The trouble is that while there are lots of MPs who want to work together in a spirit of goodwill in this place, there are also people who are natural wreckers – and they are on both sides of the House – who actually actively don’t want to see this kind of thing happen and will do everything they can to scupper it. I think that’s a shame and I think that the public should be watching.”

MPs, though, need to be upfront with the public about how to fund key services going forward, she argues, and cannot continue with the “pretence that nobody has to pay for this stuff”.

“We don’t want to have this constant ping-pong backwards and forwards. We need to recognise that the public is saying ‘yes, we want our public services properly funded’ and I think all the political parties would do themselves, and certainly the public, a big favour if they said ‘OK, we hear you, these are the options’ and take a bit from everybody’s manifesto if necessary.

“I think of course the top 5% should pay the most, but it’s unrealistic to say you can do all of this with only a tiny number of people having to pay. Because the scale of what we need on social care – it’s phenomenal,” she says.

Wollaston believes parliament should be looking years hence when deciding funding arrangements for health and social care, and believes current spending is well short of the mark.

“I think politicians are head-in-the-sand about how bad things are going to look if we carry on at the level of funding increases. I don’t doubt that there are above-inflation increases to the NHS. The trouble is, historically, the NHS has always had around 4% a year pay rise,” she says. “Since 2010, that’s been 1.1%, and at a time when demand is escalating way beyond that. So, we can’t carry on as we are and pretend it’s not going to affect services, because it’s already starting.”

It seems, then, that the former doctor has not lost her ability to diagnose problems. She is not short on prescriptions, either, and would like to see the government make a “big, bold offer” by asking Liberal Democrat MP Norman Lamb, a former health minister, to chair a commission on funding the NHS and social care. She would also like to see Keir Starmer, Labour’s Brexit spokesperson, incorporated into the government’s negotiating team.

“The key challenges of this parliament as I see it are delivering Brexit and actually making sure that our public services are in a fit state for the future. But I genuinely don’t think those two challenges can be addressed unless we see cross-party working,” she says.

Such is the fluid nature of politics that it is not until halfway through our conversation in Portcullis House that we delve into the implications of Brexit on health. Wollaston wants to see a “streamlined process” for EU staff to work in the NHS, and believes “if it ain’t broke, don’t fix it” when it comes to existing arrangements that are of “obvious mutual benefit and work well”.

“The argument is going to be about the final arbiter, and I do think there is a point that the European Court of Justice isn’t the right mechanism and I gather there is some movement on that. I hope we arrive in a position where everyone’s happy,” she says.

Wollaston became chair of the Health Select Committee in 2014. If re-elected, she would like to look at the future of medicines and devices post quitting the EU. She says it is “regrettable” that the UK is going to relinquish its membership of the European Medicines Agency, the London-based regulatory authority, and must make sure that the Britain’s pharmaceutical and life sciences industry, alongside patients, are not “disadvantaged” as a consequence.

For this Wollaston would like to see as “smooth and uninterrupted as possible” mechanism to allow the UK to carry on working with the EMA to ensure new drugs are not launched in Britain “very late”. “What nobody voted for in Brexit is to find that they had delayed access to medicines,” she argues.

Wollaston famously backed Leave only to switch allegiances to Remain during the referendum, in no small part due to Brexiters’ promise to spend an extra £350m a week on the NHS. She says she will campaign for any Brexit bonus to be diverted towards the health service, but “clearly” it will not be the figure claimed by Boris Johnson et al.

This parliamentary session, the Health Committee, under Wollaston’s prospective leadership, will also look into nursing bursaries and the nursing workforce, children and young people’s mental health, childhood obesity and the success of the sugar tax (which comes into force next year), alongside following up on the group‘s suicide prevention inquiry, end-of-life care and better births.

A vast array of work, then, that could really do without such a rude interruption as an early election. Wollaston is hopeful that this parliament can “run right through into the end of the Brexit process”, with Theresa May the “right person” to lead Britain into those negotiations.

In Wollaston’s eyes the unexpected election result offers up an opportunity for parliament to salvage its reputation. And the stakes couldn’t be higher. “It’s make or break time,” she says.

“Politicians have to take a good hard look at the way the public view us and say ‘they are watching, are we going to work together, or are we just going to have two years or more of just a shouting match’, which just looks very unedifying, achieves nothing and leaves the public holding us in even lower esteem.